Relationship Between Obstetric Complications, Delivery Outcome And Pregnancy Weight Of Pregnant Women Who Have Different Pre-pregnancy Weight

Part1 Relationship between obstetric complications,delivery outcome and Different pre-pregnancy weight and pregnancy weight gainObjective:To understand the relationship between obstetric complications,delivery outcome and different pre-pregnancy weight and pregnancy weight gain, to approach the appropriate range of the pre-pregnancy weight and pregnancy weight gain, in order to provide the scientific basis of clinical pregnancy care.Methods:747 cases of primipara were divided into four groups according to pre-pregnancy body mass index:thin group (BMI<18.7), normal weight group (normal group 18.7≤BMI<23), overweight group (23≤BMI<25), obese group (BMI≥25), were divided into three groups according to different ranges of body weight increase during pregnancy (△W):△W<15kg, kg15≤△W<20kg,20kg≤△W.To record pregnant women's pre-pregnancy weight and measured height a month before delivery,, the pre-hospital childbirth weight, pregnancy complications (pregnancy-induced hypertension, gestational diabetes), mode of delivery, birth complications (postpartum hemorrhage, birth process block), neonatal birth weight, macrosomia, neonatal Apgar's score and perinatal concurrent syndrome (fetal distress, neonatal asphyxia, neonatal jaundice), calculation of pre-pregnancy body mass index (BMI), weight gain during pregnancy.To compare the relationgship of obstetric complications and delivery outcome between different groups.Results:(1)The rate of birth process block and uterine-incision delivery of thin group, normal group, overweight group and obese group had statistically significant difference (P<0.05). The obese group was one of risk factors (RR>1) in uterine-incision delivery.(2)Pregnancy-induced hypertension, gestational diabetes, neonatal body weight,fetal macrosomia and weight gain during pregnancy were compared statistically significant difference (P<0.05) between thin group, normal group, overweight and obesity, with pre-pregnancy weight gain, the incidence of hypertensive, gestational diabetes,and fetal macrosomia disorders in pregnancy gradually increased, a gradual increase in birth weight, pregnancy weight gain, reduced gradually. Overweight and obesity, the incidence of pregnancy-induced hypertension group and gestational diabete group weresignificantly higher than thin group, normal group, overweight and obesity were similar. The overweight group and obese group were risk factors in pregnancy-induced hypertension and gestational diabetes (RR>1).(3) Fetal distress, neonatal jaundice, neonatal asphyxia and postpartum hemorrhage had no statistical significance (P> 0.05) between thin group, normal group, overweight and obesity.(4) Pregnancy weight gain<15kg,15～20kg,≥20kg,the incidence of pregnancy induced hypertension and fetal macrosomia between the two groups were statistically significant different(P<0.05), birth weight in each group comparison werestatistically significant different (P<0.01). Pregnancy weight gain≥15kg was one of risk factors (RR>1) in fetal macrosomia.(5) Pregnancy weight<15kg,15～20kg,≥20kg,postpartum hemorrhage, abor block, dystocia cesarean section, fetal distress,fetal pathologic jaundice and neonatal asphyxia had no significant difference (P> 0.05).(6).Pregnancy weight≥15kg,gestational diabetes significantly lower than pregnancy weight <15kg group. Pregnancy weight gain≥15kg was protective factors(RR< 1).(7)There was a negative correlation between pre-pregnancy weight and pregnancy weight gain(r=-0.132,P<0.001).(8)Therewere positive correlations between pre-pregnancy weight, pregnancy weight gain and prenatal weight (P<0.001).Conclusion:Properly controling pre-pregnancy weight and pregnancy weight gain in a certain range can significantly reduce the occurrence of pregnancy-induced hypertension, gestational diabetes,production process block, neonatal body weight,fetal macrosomia,cesarean section rate and improve the health of mother and child. This study suggests that the best weight range:18.5≤pre-pregnancy BMI<23, pregnancy weight gain<15kg. Part 2 Relationship between obstetric complications,pregnancy outcome anddifferent prenatal weightObjective:To understand the relationship between obstetric complications,delivery outcome and different prenatal weight,to explore the scope of pregnancy obesity.Methods:747 cases of primipara were divided into four groups according to the different prenatal weight:group A (BMI<26), group B (26≤BMI<28), group C (28≤BMI<30), group D (30≤BMI); were divided into four groups according to the absolute value of antepartum weight:group a(W<65kg), group b (65kg≤W<75kg), group c (75kg≤W<85kg), group d (W≥85kg). To record pregnant women's pre-pregnancy weight and measured height a month before delivery, the pre-hospital childbirth weight, pregnancy complications (pregnancy-induced hypertension, gestational diabetes), mode of delivery, birth complications (postpartum hemorrhage, birth process block), neonatal birth weight, macrosomia, neonatal Apgar's score and perinatal concurrent syndrome (fetal distress, neonatal asphyxia, neonatal jaundice), calculation of pre-pregnancy body mass index (BMI), weight gain during pregnancy.To compare the relationgship of obstetric complications and delivery outcome between different groups.Results(1).The pregnancy-induced hypertension, birth weight,fetal macrosomia, abor block, dystocia cesarean section, pregnancy weight gain and pre-pregnancy weight had a statistically significant difference between the two groups of group A, group B, group C, group D and group a, group b, group c, group d (P<0.001). Group D and group c,group d were risk factors in pregnancy-induced hypertension (RR>1).Group D and group d were risk factors in birth process block and uterine-incision delivery (RR>1).Group C, group D and group b, group c, group d were risk factors in fetal macrosomia (RR>1).(2)Pre-delivery body mass index would increase higher when pre-pregnancy weight become higher.(3)Postpartum hemorrhage, gestational diabetes,fetal distress,neonatal asphyxia and neonatal jaundicehad no statistically significant difference between the two groups of group A, group B, group C, group D and group a, group b, group c, group d (P> 0.05). ConclusionDifferent pre-pregnancy weight,, there are different appropriate range of pregnancy weight gain, the final pre-delivery weight should be controlled appropriately, in order to reduce the obstetric complications and the occurrence of adverse pregnancy outcomes. This study suggests that the best range of pre-delivery 1 body mass index and weight:BMI<28, W<75kg.